The most common causative organism of afebrile pneumonia of infancy is:

Correct Answer: D

Rationale: The correct answer is D) Chlamydia trachomatis. Afebrile pneumonia in infancy is commonly caused by Chlamydia trachomatis, an intracellular organism that infects the respiratory epithelium. This pathogen is known to cause respiratory infections in infants, particularly in the first few months of life. Option A) Staphylococcus is less likely to cause afebrile pneumonia in infants compared to Chlamydia trachomatis. Staphylococcus is more commonly associated with skin infections and certain types of respiratory infections in older children and adults. Option B) Hemophilus influenza is a common cause of respiratory infections in children, but it is not the most common causative organism of afebrile pneumonia in infancy. Hemophilus influenza is more commonly associated with acute otitis media and bacterial meningitis in children. Option C) Streptococcus pneumoniae is a leading cause of bacterial pneumonia in children and adults, but it is not typically associated with afebrile pneumonia in infancy. Streptococcus pneumoniae commonly causes pneumonia with symptoms such as fever, cough, and respiratory distress. Educationally, understanding the common causative organisms of pediatric respiratory infections is crucial for healthcare providers working with infants and young children. Recognizing the specific pathogens involved helps in accurate diagnosis, appropriate treatment, and prevention strategies. In the case of afebrile pneumonia in infancy, knowledge of Chlamydia trachomatis as a common causative organism is important for providing effective care to this vulnerable population.

Correct Answer: B

Rationale: The correct answer is B) Bacterial Meningitis. In a 5-year-old girl with altered mental status and cerebrospinal fluid (CSF) findings of high white blood cells (WBCs) with 80% neutrophils, low sugar, and high protein, the most likely diagnosis is bacterial meningitis. Bacterial meningitis is characterized by a high number of neutrophils in the CSF, along with low glucose and high protein levels. This pattern of CSF findings suggests an acute bacterial infection. Bacterial meningitis is a medical emergency that requires prompt diagnosis and treatment with antibiotics to prevent serious complications such as brain damage or death. The other options are incorrect because: A) Normal: The clinical presentation and CSF findings described do not indicate a normal state; they suggest an inflammatory process. C) Viral encephalitis: Viral encephalitis typically presents with lymphocytic pleocytosis in the CSF, rather than neutrophil predominance. D) TB Meningitis: While TB Meningitis can present with similar CSF findings, in this case, the high percentage of neutrophils is more suggestive of acute bacterial meningitis. In an educational context, understanding the different etiologies of meningitis and the corresponding CSF findings is crucial for pediatric nurses to provide timely and appropriate care to children with suspected central nervous system infections. Recognizing the specific patterns in CSF analysis can help nurses advocate for prompt diagnostic testing and treatment to improve patient outcomes.

Correct Answer: C

Rationale: In hemophilia A, which is a genetic disorder caused by a deficiency in clotting factor VIII, the correct answer is C) Prolonged APPT (Activated Partial Thromboplastin Time). This is because hemophilia A specifically affects the intrinsic pathway of the coagulation cascade, leading to a prolonged APPT due to the deficiency of factor VIII. Option A) Prolonged bleeding time is incorrect because bleeding time primarily assesses platelet function, not the clotting factors affected in hemophilia A. Option B) Prolonged prothrombin time is incorrect because prothrombin time evaluates the extrinsic pathway of the coagulation cascade, which is not primarily affected in hemophilia A. Option D) Prolonged thrombin time is incorrect because thrombin time measures the conversion of fibrinogen to fibrin, which is not directly impacted in hemophilia A. Educationally, understanding the specific clotting factors involved in hemophilia A and how they affect different parts of the coagulation pathway is crucial for nurses caring for pediatric patients with this condition. Recognizing the unique laboratory findings in hemophilia A can guide appropriate treatment strategies and interventions to prevent bleeding complications in these patients.

Correct Answer: D

Rationale: In roseola infantum infection, also known as sixth disease, the characteristic skin rash typically appears once the fever subsides. This is because the rash is a result of the body's immune response to the virus causing the fever. As the body fights off the infection, the fever eventually decreases, and the rash emerges. Option A) 1st day of fever is incorrect because the rash does not appear at the onset of fever. Option B) 3rd day of fever is incorrect as well, as the rash usually appears after the fever has been present for some time. Option C) 4th day of fever is also incorrect; the rash typically appears after this point. From an educational perspective, understanding the timing of the appearance of the rash in roseola infantum is crucial for nurses caring for pediatric patients. Recognizing the progression of symptoms can aid in accurate diagnosis and appropriate management of the infection. This knowledge helps healthcare professionals provide quality care and education to families about the course of the illness.

Correct Answer: B

Rationale: In this scenario, the correct answer is B) Prostaglandin E1. Infants with marked cyanotic heart defects and decreased pulmonary vascularity often have conditions like ductal-dependent congenital heart diseases (CHD) where a patent ductus arteriosus (PDA) is necessary to maintain systemic blood flow. Prostaglandin E1 helps keep the ductus arteriosus open, allowing for adequate systemic blood flow in these infants. Option A) Epinephrine is used in situations of cardiac arrest or severe hypotension, not specifically for treating cyanotic heart defects. Option C) Dopamine is a medication used to improve cardiac output and blood pressure, but it is not the primary treatment for cyanotic heart defects. Option D) Digoxin is a cardiac glycoside used to treat heart failure and certain arrhythmias, but it is not the appropriate treatment for cyanotic heart defects with decreased pulmonary vascularity. Educationally, understanding the importance of prostaglandin E1 in managing ductal-dependent CHD in infants is crucial for pediatric nursing practice. This knowledge ensures timely and appropriate interventions to support these vulnerable patients, highlighting the significance of accurate medication administration in pediatric cardiac care.